“The patriarchy begins at home,” acclaimed Atlanta-based novelist Tayari Jones told the Atlantic last year. “They call it ‘patriarchy’ because it’s about your father and your brothers and your family.” My brother became a conservative Republican in the late ’80s due in part to a strong moral opposition to abortion. He’s 16 years older than me, and one of few men in our family. We were raised in the same missionary Baptist church in North Memphis our family belonged to for three generations. I was baptized and went to Sunday School there; my grandmother had been a white glove-wearing, note-taking member of the Baptist Training Union 50 years before. They taught Baptist doctrine to congregants. I found pages of her meticulous notes in a closet in my auntie’s house decades after she died. Despite years of service and prominent roles in the church, women couldn’t sit in its pulpit, much less aspire to ultimate leadership. In all of my time there, I can’t even recall having a woman from another congregation speak to us as visiting pastor.

The seeds of whatever belief system my brother came to uphold must have been planted in that sanctuary. Later, when I was a teenager who’d developed her own thoughts on the matter, we spoke about the biblical underpinnings of his values. We didn’t talk about our grandmother, who may have had an abortion in the ’50s when she became pregnant for the ninth time. Or our mother, who, with me, had a troubled delivery, with preeclampsia, induction, and a caesarian section. I spent my first days in a neonatal ICU. My mother was 21 when my brother was born and 37 with me — an “advanced maternal age.” By the time my brother and I were talking about the “sanctity of life,” it was the ’90s; yet, even now, when male pundits and politicians speak about pregnancy, abortion, and God, I do not hear a concern for the lives and experiences of would-be mothers, for women, that is as strong as their concern for the unborn.

It’s likely, since Brett Kavanaugh replaced Anthony Kennedy and the Supreme Court’s ideological balance shifted, that federal protections guaranteed with Roe vs. Wade will disappear. Several cases that would prompt its annulment could make it onto the Court’s docket. Many people already effectively live in a post-Roe future. In states throughout the South and Midwest, including my home state of Tennessee, more than 90% of counties have no clinics that provide abortion services. Mississippi and six other states are down to a single one. The Hyde Amendment prohibits use of federal Medicaid funds for elective abortions; 11 states restrict abortion coverage in private insurance. Twenty-seven require waiting periods of 24 to 72 hours, meaning two visits to a provider that is possibly already a prohibitive distance away.

New York’s Reproductive Health Act passed on January 22, 2019, the 46th anniversary of Roe v. Wade. It codified the Supreme Court decision into state law, removed abortion from the criminal code, and relaxed some restrictions on abortions after 24 weeks. Last month, Virginia’s legislature considered a bill that would also expand abortion access at the state level. Since then, the phrase “late term” abortion, an imprecise, lightning rod of a term used to describe a set of complicated procedures that account for less than 2% of abortions, shot through the discourse to, it seems, reignite a moral conversation about abortion in general. New York and Virginia are part of a rash of states that rushed to pass bills clarifying their positions. On February 20, the governor of Arkansas signed the “Human Life Protection Act”; it will “abolish abortion” in the state, except in cases where the mother’s life is in danger. Tennessee’s legislature introduced a similar bill in February. Both would become effective should Roe v. Wade, or its supporting decisions, be nullified. Mississippi, Louisiana, North Dakota and South Dakota already have comparable “trigger laws” in place.

“We lose people when we center and focus on abortion,” Jalessah Jackson told me on a phone call from Atlanta. She’s the Georgia Coordinator for SisterSong, a national, membership-based network of organizers focused on reproductive rights. Founded in 1997, one of SisterSong’s main aims is organizing in support of people all along the gender spectrum who are living in the South.

A major priority for SisterSong is “culture shift” campaigns, which develop partnerships with faith organizations and leaders. “We recognize the role of the church in people’s lives,” she said, so their organizers “meet with progressive church leaders to talk about their responsibility in making sure their congregation is living and thriving. They should attend to the part of their congregation that might want to have children as well as those that might not want to.”

Jackson and team hope to “change narratives,” because many people “think faith and reproductive justice are in opposition, and they’re not.” Indeed, the Southern Christian Leadership Conference (SCLC), started by a coalition of ministers after the successful Montgomery Bus Boycott and led, at one point, by Dr. Martin Luther King, Jr., wrote a policy document for the federal government’s family planning program in the mid-60s. Before that, in the ’30s, W.E.B. DuBois thought black churches should invite leaders of birth control organizations to speak to their congregations. DuBois had a progressive-era classism then, and believed in population control especially among the “least intelligent and fit.” But there’s something to his call for “a more liberal attitude” within the black church that remains salient.

According to Loretta J. Ross, an activist and one of the pioneers of the concept, and historian Rickie Solinger, the core of reproductive justice is the right to have a child or not, and the right to parent children in safe and healthy environments. Using reproductive justice as a frame for thinking about women’s health exposes the limits of the pro-life / pro-choice binary. It makes room for concerns about mass incarceration, public education, affordable housing, air pollution, and the ability to earn a living wage — all of which influence what choices people actually have, and determine whether the children they carry to term are able to thrive.

Nearly 60% of women who terminate pregnancies are already mothers. About half of patients seeking abortion care live below the poverty level. Black women in the US are almost three times more likely than white women to have abortions; Latinas have them nearly twice as often as whites. Since a growing majority of US blacks reside in the South, and poverty rates for blacks, Latinx, and indigenous people double that of whites, abortion access is a “race issue,” and a Roe annulment would disproportionately affect brown and black people. Many black pro-life organizations and church congregations have co-opted the language of progressive movements to buttress their opposition to abortion, linking reproductive rights and family planning with genocide. It’s an old but powerful strain of thinking that acknowledges medical racism and the early associations of Margaret Sanger, a founder of Planned Parenthood, with leading eugenicists. But it fails to note Sanger’s reliance on W.E.B. DuBois’ research, and it does not account for the lived experiences or needs of actual women.

Nikia Grayson, certified nurse midwife and director of midwifery care at Choices, a reproductive health center in downtown Memphis, told me their providers like to “talk about all of a woman’s options,” to unearth and address what kind of care she needs. They aim to provide “high quality, non-judgmental” healthcare in which they remove the stigma from abortion and serve the needs of the city’s LGBTIA population. They are one of few clinics providing the HIV preventative medications PrEP and PEP in a city that is eighth in the country for rates of new HIV diagnoses.

Choices is a model of full spectrum reproductive care, offering prenatal and postpartum care, pap smears, pelvic exams, STI screening and advice, and (through coordination with a local rape crisis center) treatment specifically for sexual assault survivors, all under one roof. It’s the midwifery model, in which women are attended to “from menarche to menopause.” Abortions are also provided at the facility. One of only two back certified nurse midwives in Memphis, Grayson said the majority of Choices’ patients pay for their services at least partially with Medicaid, and the center often raises funds to cover what the state will not. If all goes according to plan, later this year they’ll open the city’s first standalone birthing center, where women who could not otherwise afford a home birth can have an alternative to hospital delivery. Advisers to the World Health Organization and the UN Population Fund recommend “integrated comprehensive sexual and reproductive health services” like this “for women and girls to enjoy their human rights.” It decreases the likelihood of unintended pregnancies, addressing concerns about abortion closer to the root.

I asked Grayson about church groups, and she said Choices receives support from social justice oriented congregations, like Christ Missionary Baptist Church. “They understand that the work Choices does saves lives.” Christ Missionary’s senior pastor, Dr. Gina Stewart, is one of the first women to lead a Baptist congregation in the city and its surrounding areas.

If Roe is dying, it is, so far, a slow burning death, with gasps for breath and short, hopeful bouts of recovery. Several weeks ago, Chief Justice John Roberts delivered the decisive vote in blocking a law in Louisiana that would have further restricted abortion access in the state; the week after, the Trump administration published a “family planning rule” that would block providers who provide or counsel on abortions (such as Planned Parenthood and Choices) from access to certain federal funds. It is is helpful to note how institutions like Planned Parenthood, Choices and SisterSong already do their work in a climate of opposition and disinformation. “I think there’s a lot of misunderstanding about abortion.” Jaleesah Jackson said. The disinformation comes from everywhere, nowhere, and the top — the president falsely claimed in his latest state of the union address that later term abortions “rip babies from the mother’s womb moments from birth.” As Jackson said, “SisterSong advocates for comprehensive sex education, and comprehensive sex education would cover abortion. All genders, all folks need access to this information because they’re all charged with the responsibility of making decisions about their reproductive lives.”

But abortion is, in many ways, beside the point. “We’re autonomous human beings.” Jackson told me. “And part of having bodily autonomy is being able to make whatever reproductive health decisions we deem fit for ourselves and our lives and for our families.”

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